Intersection of COVID-19 and SDoH

Employment security, health insurance, and mental health are issues that are dominating care management.

The dramatic rise in unemployment has received considerable focus across the country, with so many experiencing challenges with health insurance, access to care, and added numbers of persons at risk for issues associated with the social determinants of health (SDoH). One in 10 eligible workers have filed for claims since the pandemic escalation in mid-March, with Hawaii, Kentucky, Michigan, and Rhode Island seeing one out of every five workers filing. New York State alone has the highest unemployment rate since the Great Depression, currently at 1.4 million jobless claims. Other states are seeing comparably exorbitant claims rates, including especially high percentages in California, Florida, Georgia, Michigan, Pennsylvania, and Texas.

A new combined report by SRSS and the Commonwealth Fund has confirmed the stark realities of the situation, highlighting the historic intersection of the pandemic, employment security, health insurance, and necessary access to healthcare. Over 1,000 people were surveyed the second week of April, with the following results:

  • Roughly 32 percent of adults reported they lost their job;
  • 19 percent had hours cut;
  • 9 percent experienced pay cuts, with 3 percent of those persons losing their health insurance;
  • 20 percent of those who lost jobs or had hours or pay cut did not have health insurance before the pandemic hit. This fact reinforces how many of the jobs in this population were in industries that still fail to offer health benefits.
    • This rate is higher than the overall 12 percent of working-age people who did not have health insurance before this crisis. 

The survey also mentioned the gross rise in anxiety among those who experienced a loss of employment or cuts to hours or salary. Much has been written about the massive impact of the pandemic on mental health of all populations, but this survey specifically found that:

  • 18 percent were worried they would lose their insurance.
  • 41 percent were dealing with employment, and simultaneously found themselves challenged by health coverage insecurity.
  • The Kaiser Family Foundation found that nearly 50 percent of persons who lost a job or their income felt that the virus was having a negative effect on their mental health.
  • 47 percent of people sheltering in place reported negative mental health symptoms resulting from their preoccupation specific to coronavirus, versus 37 percent of persons who were not sheltering in place. Mental health challenges from social isolation are known to be more common among older adults and households with adolescents, as these populations are also at greater risk for depression or suicidal ideation.
  • Unemployment is associated with increased rates of behavioral health issues, including depression, anxiety, stress, and low self-esteem, all potentially leading to higher rates of substance use and suicide. 

Increased costs, decreased revenue, and rapidly rising numbers of uninsured are all of deep concern to healthcare organizations. This is reflected by the fact that over 160 health systems across the country have furloughed or laid off employees, with other entities soon to join this unfortunate club. Healthcare organizations are struggling with massive costs. However, they will soon add unprecedented numbers of healthcare employees to the growing tally of those dealing with socioeconomic and psychosocial challenges, issues previously considered only for marginal and disenfranchised populations and communities served by their employers.

This week’s Monitor Mondays Listeners Survey asked listeners about their experiences with respect to the number of patients reporting lack of health insurance. The results are viewable here, yielding considerable concerns moving forward for the health and well-being of all persons.

Programming Note: Ellen Fink-Samnick is a permanent panelist on Monitor Mondays. Listen to her live reporting every Monday at 10-10:30 a.m. EST.

Facebook
Twitter
LinkedIn
Email
Print

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management and Social Determinants of Health: Case Management’s Next Frontier (with foreword by Dr. Ronald Hirsch), are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk Ten Tuesdays, and member of the RACmonitor Editorial Board.

Related Stories

Help: What Do I Do Now?

Help: What Do I Do Now?

The PHE has ended and the three-day SNF rule has returned. Following up on my previous article posted in April regarding the return of the

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering Good Faith Estimates Under the No Surprises Act: Compliance and Best Practices

Mastering Good Faith Estimates Under the No Surprises Act: Compliance and Best Practices

The No Surprises Act (NSA) presents a challenge for hospitals and providers who must provide Good Faith Estimates (GFEs) for all schedulable services for self-pay and uninsured patients. Compliance is necessary, but few hospitals have been able to fully comply with the requirements despite being a year into the NSA. This webcast provides an overview of the NSA/GFE policy, its impact, and a step-by-step process to adhere to the requirements and avoid non-compliance penalties.

Mastering E&M Guidelines: Empowering Providers for Accurate Service Documentation and Scenario Understanding in 2023

Mastering E&M Guidelines: Empowering Providers for Accurate Service Documentation and Scenario Understanding in 2023

This expert-guided webcast will showcase tips for providers to ensure appropriate capture of the work performed for a visit. Comprehensive examples will be given that demonstrate documentation gaps and how to educate providers on the documentation necessary to appropriately assign a level of service. You will gain clarification on answers regarding emergency department and urgent care coding circumstances as well as a review of how/when it is appropriate to code for E&M in radiology and more.

June 21, 2023
Breaking Down the Proposed IPPS Rule for FY 2024: Top Impacts You Need to Know

Breaking Down the Proposed IPPS Rule for FY 2024: Top Impacts You Need to Know

Set yourself up for financial and compliance success with expert guidance that breaks down the impactful changes including MS-DRG methodology, surgical hierarchy updates, and many new technology add-on payments (NTAPs). Identify areas of potential challenge ahead of time and master solutions for all 2024 Proposed IPPS changes.

May 24, 2023

Trending News